Determinants of living well With aphasia in the first year poststroke: a prospective cohort study

Worrall, Linda E., Hudson, Kyla, Khan, Asaduzzaman, Ryan, Brooke and Simmons-Mackie, Nina (2017) Determinants of living well With aphasia in the first year poststroke: a prospective cohort study. Archives of Physical Medicine and Rehabilitation, 98 2: 235-240. doi:10.1016/j.apmr.2016.06.020

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Author Worrall, Linda E.
Hudson, Kyla
Khan, Asaduzzaman
Ryan, Brooke
Simmons-Mackie, Nina
Title Determinants of living well With aphasia in the first year poststroke: a prospective cohort study
Journal name Archives of Physical Medicine and Rehabilitation   Check publisher's open access policy
ISSN 1532-821X
Publication date 2017-02-01
Sub-type Article (original research)
DOI 10.1016/j.apmr.2016.06.020
Open Access Status File (Author Post-print)
Volume 98
Issue 2
Start page 235
End page 240
Total pages 6
Place of publication Maryland Heights, MO, United States
Publisher W.B. Saunders Co.
Collection year 2018
Language eng
Formatted abstract
Objective: To determine factors that contribute to living well with aphasia in the first 12 months poststroke.

Design: Prospective longitudinal cohort study.

Setting: Hospitalized care, ambulatory care, and general community.

Participants: A referred sample of people (N=58) with a first incidence of aphasia after stroke was assessed at 3, 6, 9, and 12 months postonset. Participants were recruited through speech-language pathologists in 2 capital cities in Australia. Presence of aphasia was determined through the Western Aphasia Battery-Revised by an experienced speech-language pathologist.

Interventions: Not applicable.

Main Outcome Measures: The main outcomes were the 5 domains of the Assessment for Living with Aphasia at 3, 6, 9, and 12 months poststroke. The independent variables included demographics, physical functioning, social network, mood, aphasia severity, and a self-rating of successfully living with aphasia at the same time points. Mixed effects modeling was used to determine which factors contributed to the trajectory of each of the 5 domains of participation, impairment, environment, personal factors, and life with aphasia.

Results: Higher household income, larger social network size, being a woman, and having milder aphasia were positively associated with the participation domain. Graduate or postgraduate educational levels, low mood, and poor physical functioning were negatively associated with the participation domain. Factors positively associated with other domains included higher income, self-ratings of successfully living with aphasia, and aphasia severity. Low mood was consistently negatively associated with all of the domains.

Conclusions: Psychosocial determinants were the most significant predictors of living well with aphasia in the first 12 months postonset. Aphasia rehabilitation needs to attend more to these factors to optimize outcomes.
Keyword Aphasia
International classification of functioning, disability and health
Language disorders
Patient outcome assessment
Quality of life
Social determinants of health
Speech-language pathology
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: HERDC Pre-Audit
School of Health and Rehabilitation Sciences Publications
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